EVALUATING LIFESTYLE, DIETARY, AND PHARMACOLOGICAL INTERVENTIONS IN THE MANAGEMENT AND PREVENTION OF HYPERTENSION AMONG DIVERSE POPULATION GROUPS: A SYSTEMATIC REVIEW

Abstract

Background: Hypertension remains a critical global health burden and a primary modifiable risk factor for cardiovascular disease. Despite a multitude of available interventions, optimal strategies for management and prevention across diverse demographic and risk groups are not fully elucidated, necessitating a synthesized evaluation of contemporary evidence.

Objective: This systematic review aimed to evaluate the effectiveness of lifestyle, dietary, and pharmacological interventions in controlling and preventing hypertension among diverse population groups.

Methods: A systematic search of PubMed, Scopus, Web of Science, and the Cochrane Library was conducted for studies published between 2019 and 2024. The review included randomized controlled trials and prospective cohort studies that assessed the impact of these interventions on systolic and/or diastolic blood pressure in adult populations. Study selection, data extraction, and risk of bias assessment were performed by two independent reviewers following PRISMA guidelines.

Results: Eight studies (n=11,542 participants) were included. The evidence demonstrated that intensive, multi-component lifestyle interventions produced substantial blood pressure reductions (e.g., -10.2/-5.6 mmHg). Culturally-tailored dietary approaches and technology-enabled strategies (e.g., mHealth for salt reduction) showed significant efficacy. Pharmacologically, spironolactone was highly effective in resistant hypertension, and low-dose triple therapy provided superior control in elderly patients compared to monotherapy. The overall strength of evidence was moderate, though significant clinical and methodological heterogeneity precluded a meta-analysis.

Conclusion: Structured and personalized interventions are effective for hypertension control across diverse populations. The findings support a paradigm shift towards tailored lifestyle and pharmacological strategies rather than a uniform approach. Future research should focus on long-term outcomes and identifying predictive factors for personalized intervention selection to optimize public health impact.